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s��-�ao-oozo Cifij of Zephyrhills�Fire• Fax-8�3-7so-oozl <br /> Permit Applicstion <br /> late Received - Phone Contact for P ��m� <br /> >w�5:�_:._.,��:::;;�tu���.,.�..,..W..,.._. ermit <br /> ,..a..—,-, ���a���,�*+�, ��--xs ,........,.�_...,. - . <br /> hvners Name �` r" � • �� Owner's Phone Number � 9 � ��(� <br /> �wners Address (� X o�G1 g f 5,3�� c(S��''�'� S �� �� S � I 33 <br /> =ee Simple'Citleholder Name Titlehoider Phone Number C� � <br /> =es SimpleTitleholderAddress <br /> �i�..',':'zF..i:'w:s�.:�a"" ��_ - . <br /> �•��.,.,..�—_.ms�e_arns.�..=_?� u�ss:r��.,..,��a"�!',�.LL�.i�.`�:.�:f'?°'t"-.�,a�SS°,�= <br /> Ja6 Address `��C� Z " � � <br /> -- � � , �S ot# LC <br /> SubDivision � ZQ � Parcel# l� �p—� �(�✓C� �5vZ0(J -Ui �� <br /> �i.5�:�,:-F.•�-,•,p.•;£2��a-�"^`'r.!i4`n1:m'�'`W- - <br /> - . "i�.::S�":te'v'xks=��'u�.�"k'i'r'.t::.'.su::E;i�s,y:=i.g';5.YE-:�':Ku <br /> � Bio-Hazard Waste 5torage-ANNUAL � Fumigatlon Tent <br /> � Comm Exhaust K'�tchen HoodlDuct � Hazardous Material�Tier II or RQ Facility}ANNUAL <br /> � ConVoiled Bum � Hood Installatlon <br /> � Emergency Ganerator<30 kw � LP/Natura)Gas-Installation � <br /> � <br /> Emergency Generator>3D kw � LP/Naturai Gas-AfVNUAL 5ale <br /> Firs Prote�tion Mairrtenance-ANNUAL � Piaces of Assembly-ANNUAL I., <br /> Rry emt ATn er ��l/ <br /> Sprinkler � ❑ p ❑ � � Recreatlonal Bum � <br /> � ° ° � <br /> Fire Alarm ❑ ❑ y� Sparklers <br /> Hood Cleaning [7 O !❑ � Sprinkler System Installatlon <br /> Hood Suppressiun � ❑ ❑ ❑ C� � Standpipes(Sprinkler Sys) <br /> � Fire Alartn Installati�n � Torcfi RoofinglTar KetUe <br /> Fire Pumps � Waste Tire Stotage ANNUAL <br /> Fire 1Norks • <br /> Fiammable Apptication-ANNUAL r�'�� Vafuation of Project <br /> Fue{Tanks <br /> �] Other: <br /> �$���.�-���.�,�� <br /> ConVactor �y�t�����������' <br /> � - - <br /> Comparry � > ',. , :� .� � "ird �`� t;, <br /> 5ignature ' Registered Y N Fee Current N <br /> Address a' ►c \}� - -� - ` �-.�.- <br /> License# ;�V ��} <br /> ELECTRICIAN � Company <br /> Signature Registered Y/N Fes Current Y/�— <br /> Address Lfcense# <br /> PLUMBER � � Company <br /> 5ignature ReglStered �'/N Fee Cutrent Y/N <br /> Address <br /> Licensa# <br /> MECHANICAL Company <br /> Signature Registered 1'/(� Fee Current Y/N <br /> Address — <br /> License# <br /> OTHER <br /> Company <br /> 5lgnature Registered Y/N Fee Current Y I N <br /> Address <br /> �a�-����- License# <br /> Directions: �-b,,�.��sa� ..a�.a —__..._.....�.._.:.:.�sss � ..�. ,.>T—�y�....,_..�_.ti..��tau;�� <br /> �._� <br /> Fill aut application completely. <br /> Owner 8,Contractor sign back ofi applicatior�,notarized(Or,copy of slgned ovntract with owner) <br /> If over$2500,a Notice of Commencement is required(Mechanica!work over 35000) <br /> Supply two(2}sets of drawings with applicable documentation <br /> Allow 10-14 days for rnvisw after submittal date. Parcel#-obtained from Property Tax Notice(http:!/appraiser.pascogov.com) <br />